Healthcare Provider Details

I. General information

NPI: 1053752840
Provider Name (Legal Business Name): CARIN E. HURT LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2013
Last Update Date: 07/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8401 HARCOURT RD
INDIANAPOLIS IN
46260-2036
US

IV. Provider business mailing address

10330 N MERIDIAN ST SUITE
INDIANAPOLIS IN
46290-1024
US

V. Phone/Fax

Practice location:
  • Phone: 317-338-4800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number39002484A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: